Individual provider Active NPI

Agostinho M. Oliveira, D.C.

  • Chiropractor
  • St Augustine, FL
National Provider Identifier
1285729871
Registry record updated May 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9245 Issued in FL
Practice address
163 Hampton Point Dr
Suite 4
St Augustine, FL 32092-3059
Phone
(904) 230-2717
Fax
(904) 230-2720
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9245 FL Primary
Chiropractor 111N00000X X008831-1 NY
Chiropractor 111N00000X 0104555764 VA

Addresses

Primary practice location

163 Hampton Point Dr
Suite 4
St Augustine, FL 32092-3059

Mailing address

163 Hampton Point Dr
Suite 4
St Augustine, FL 32092-3059
Phone (904) 230-2717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070509000366 FL Practitioner - Chiropractic 1951379502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

163 Hampton Point Dr
Suite 4
St Augustine, FL 32092-3060
Phone (904) 230-2717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH9245FLMDChiropractor
X008831-1NYMDChiropractor
0104555764VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
210 Family Chiropractic Center LLC Chiropractor CurrentSince Jun 1, 2006 Accepting new patients

Locations

163 Hampton Point Dr
Ste 4
Saint Augustine, FL 32092
Phone (904) 230-2717

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242345600000",
    "number": "1285729871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 HAMPTON POINT DR",
            "address_2": "SUITE 4",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923059",
            "telephone_number": "904-230-2717",
            "fax_number": "904-230-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 HAMPTON POINT DR",
            "address_2": "SUITE 4",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923059",
            "telephone_number": "904-230-2717",
            "fax_number": "904-230-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVEIRA",
        "first_name": "AGOSTINHO",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9245",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008831-1",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555764",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.